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Annate arretrate

Rivista Italiana di Medicina Legale e del Diritto in campo sanitario

Rivista: Rivista Italiana di Medicina Legale (e del Diritto in campo sanitario)
Anno: 2019
Fascicolo: n. 1
Editore: Giuffrè Francis Lefebvre
ISSN: 1124-3376
Autori: Oliva Antonio, Grassi Simone, Pascali Vincenzo L.
Titolo: SULL’IMPERIZIA DELL’ESERCENTE LA PROFESSIONE SANITARIA AI SENSI DELL’ART. 590-SEXIES C.P. PROSPETTIVE MEDICO-LEGALI E PENALISTICHE A CONFRONTO. IL PARERE DEL MEDICO LEGALE L’imperizia dopo la Legge n. 24 del 2017: per avere un porto sicuro servono confini chiari
Pagine: pp. 430-441

Abstract non disponibile per questo articolo

SULL’IMPERIZIA DELL’ESERCENTE LA PROFESSIONE SANITARIA AI SENSI DELL’ART. 590-SEXIES C.P. PROSPETTIVE MEDICO-LEGALI E PENALISTICHE A CONFRONTO. IL PARERE DEL MEDICO LEGALE L’imperizia dopo la Legge n. 24 del 2017: per avere un porto sicuro servono confini chiari


1) American College of Legal Medicine, The Medical Malpractice Survival Handbook, 2007, Mosby.
2) M.A. Makary, M. Daniel, Medical error-the third leading cause of death in the US, in BMJ, 2016, 353:i2139.
3) M.M. Mello, A. Chandra, A.A. Gawande, D.M., National costs of the medical liability system, in Health Aff (Millwood), 2010, 29(9):1569-77.
4) Commissione parlamentare di inchiesta sugli errori in campo sanitario e sulle cause dei disavanzi sanitari regionali. Relazione conclusiva. Approvata dalla commissione nella seduta del 22 gennaio 2013.
5) T. Delbanco, S.K. Bell, Guilty, afraid, and alone-struggling with medical error, in New Engl J Med., 2007.
6) F. Basile, Itinerario giurisprudenziale sulla responsabilità medica colposa tra art. 2236 cod. civ. e Legge Balduzzi (aspettando la riforma della riforma), in Diritto penale contemporaneo, 2017.
7) L., Donaldson, An organisation with a memory, in Clin Med JRCPL, 2002, 2:452–7.
8) P. McCulloch, A. Mishra, A. Handa, T. Dale, G. Hirst, K. Catchpole, The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre, in Qual. Saf. Health Care, 2009, 18;109-115.
9) S.O. Rogers Jr, A.A. Gawande, M. Kwaan, A.L. Puopolo, C. Yoon, T.A. Brennan, D.M. Studdert, Analysis of surgical errors in closed malpractice claims at 4 liability insurers, in Surgery, 2006, 140(1):25-33.
10) Institute of Medicine (US) Committee on Quality of Health Care in America; L.T. Kohn, J.M. Corrigan, M.S. Donaldson, editors, To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US), 2000.
11) A. Kachalia, M.M. Mello, B.K. Nallamothu, D.M. Studder, Legal and Policy Interventions to Improve Patient Safety, in Circulation, 2016, 133(7):661-71.
12) B. Sonny Bal, An Introduction to Medical Malpractice in the United States, in Clin Orthop Relat Res, 2009.
13) P.P. Budetti, T.M. Waters, Medical Malpractice Law in the United States, Kaiser Family Foundation, 2005.
14) M. Caputo, “Filo d’arianna” o “flauto magico”? Linee guida e checklist nel sistema della responsabilità per colpa medica, in Diritto penale contemporaneo, 2012.
15) M.M. Mello, A. Kachalia, D.M. Studdert, Medical Liability - Prospects for Federal Reform, in N Engl J Med, 2017, 376(19):1806-1808.
16) A. Kachalia, A. Little, M. Isavoran, L.M. Crider, J. Smith, Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians, in Health Affairs, 2014, 59-66.
17) M.M. Mello, A, Kachalia, Medical malpractice: evidence on reform alternatives and claims involving elderly patients, Washington, 2016, DC: Medicare Payment Advisory Commission.
18) National Academies of Sciences, Engineering, and Medicine, Improving diagnosis in health care, Washington, 2015, DC: The National Academies Press.
19) C. Brusco, Cassazione e responsabilità penale del medico. Tipicità e determinatezza nel nuovo art. 590-sexies c.p., in Diritto penale contemporaneo, 2017.
20) Cass. Pen. Sez. IV, 9 aprile 2013, n. 16237.
21) M.J. Mehlman, Medical Practice Guidelines as Malpractice Safe Harbors: Illusion or Deceit?, in J Law Med Ethics, 2012, 40(2):286-300.
22) P. Glasziou, Evidence based medicine and the medical curriculum, in BMJ, 2008, 337-a1253.
23) Disponibili su https://snlg.iss.it (Visionato il 25 gennaio 2019).
24) R.B. D’Agostino Sr, B.J. Ansell, S. Mora, H.M. Krumholz, Clinical decisions. The guidelines battle on starting statins, in N Engl J Med., 2014.
25) Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Guidelines for the Use of Laparoscopy during Pregnancy, 2017.
26) Diagnosi e trattamento delle epilessie. Linee Guida - Consiglio Sanitario Regionale - Regione Toscana 2014.
27) R. Blaiotta, La responsabilità medica: nuove prospettive per la colpa, in Diritto Penale Contemporaneo, 2010.
28) P. Glasziou, A. Burls, R. Gilbert, Evidence based medicine and the medical curriculum, in BMJ, 2008, 337-a1253.
29) M. Caputo, Colpa penale del medico e sicurezza delle cure, Giappichelli Editore, 2017.
30) N.J. Dedy, E.M. Bonrath, N. Ahmed, T.P. Grantcharov, Structured Training to Improve Nontechnical Performance of Junior Surgical Residents in the Operating Room: A Randomized Controlled Trial, in Ann Surg, 2016, 263(1):43-9.
31) R. Krage, L. Zwaan, L. Tjon Soei Len, M.W. Kolenbrander, D. van Groeningen, S.A. Loer, C. Wagner, P. Schober, Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?, in Emerg Med J, 2017, 34(11):728-733.
32) R.A. Agha, A.J. Fowler, N. Sevdalis, The role of non-technical skills in surgery, in Ann Med Surg (Lond), 2015, 4(4):422-7.
33) T.C. Wood, N. Raison, S. Haldar, O. Brunckhorst, C. McIlhenny, P. Dasgupta, K. Ahmed, Training Tools for Nontechnical Skills for Surgeons-A Systematic Review, in J Surg Educ, 2017, 74(4):548-578.
34) S. Yule, R. Flin, S. Paterson-Brown, N. Maran, Non-technical skills for surgeons in the operating room: a review of the literature, 2006, Surgery;139(2):140-9.
35) M.A. Abid, Y.W. Li, C.W. Cummings, N.I. Bhatti, Patient outcomes as a measure of surgical technical skills: Does surgical competency matter?, in A systematic review. Otorinolaringologia, 2016.
36) J.D. Birkmeyer, J.F. Finks, A. O’Reilly, M. Oerline, A.M. Carlin, A.R. Nunn, J. Dimick, M. Banerjee, N.J. Birkmeyer, Michigan Bariatric Surgery Collaborative, Surgical skill and complication rates after bariatric surgery, in N Engl J Med, 2013, 369(15):1434-42.
37) K.R. Ghani,D.C. Miller, S. Linsell, A. Brachulis, B. Lane, R. Sarle, D. Dalela, M. Menon, B. Comstock, T.S. LendvayS, J. Montie, J.O. Peabody, Michigan Urological Surgery Improvement Collaborative, Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy, in Eur Urol, 2016, 69(4):547-550. doi: 10.1016/j.eururo.2015.11.028. Epub 2016 Jan 2.
38) K. Moorthy, Y. Munz, S.K. Sarker, A. Darzi, Objective assessment of technical skills in surgery, in BMJ, 2003, 327(7422):1032-7.
39) V.L. Pascali, Legalità e eticità nelle condotte mediche. Alcune considerazioni all’ombra della legge Gelli-Bianco, in Medicina e Morale, 2018, 6: 613-617.
40) C.M. Schulz, M.R. Endsley, E.F. Kochs, A.W. Gelb, K.J. Wagner, Situation Awareness in Anesthesia, in Anesthesiology, 2013, 118:729-42.
41) M.A. Corvetto, C. Fuentes, A. Araneda, P. Achurra, P. Miranda, P. Viviani, F.R. Altermatt, Validation of the imperial college surgical assessment device for spinal anesthesia, in BMC Anesthesiol, 2017, 17(1):131.
42) E.X. Vivas, M.L. Carlson, B.A. Neff, N.T. Shepard, J. McCracken, A.D. Sweeney, J.J. Olson, Congress of Neurological Surgeons, Systematic Review and Evidence-Based Guideline on Intraoperative Cranial Nerve Monitoring in Vestibular Schwannoma Surgery, 2017.
43) J. Bergs, J. Hellings, I. Cleemput, Ö Zurel, V. De Troyer, M. Van Hiel, J.L. Demeere, D. Claeys, D. Vandijck, Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications, in Br J Surg, 2014, pp. 150–8.
44) D. Ban, M. Tanabe, H. Ito, Y. Otsuka, H. Nitta, Y. Abe, Y. Hasegawa, T. Katagiri, C. Takagi, O. Itano, H. Kaneko, G. Wakabayashi, A novel difficulty scoring system for laparoscopic liver resection, in J Hepatobiliary Pancreat Sci, 2014, 21:745–753.
45) C. Im, J.Y. Cho, H.S. Han, Y.S. Yoon, Y. Choi, J.Y. Jang, H. Choi, J.S. Jang, S.U. Kwon, Validation of difficulty scoring system for laparoscopic liver resection in patients who underwent laparoscopic left lateral sectionectomy, in Surg Endosc, 2017, 31(1):430-436.
46) H. Uchida, Y. Iwashita, K. Saga, H. Takayama, K. Watanabe, Y. Endo, K. Yada, M. Ohta, M. Inomata, Clinical Utility of the Difficulty Scoring System for Predicting Surgical Time of Laparoscopic Liver Resection, in J Laparoendosc Adv Surg Tech A, 2016, 26(9):702-6.
47) S. Tanaka, S. Kubo, A. Kanazawa, Y. Takeda, F. Hirokawa, H. Nitta, T. Nakajima, T. Kaizu, H. Kaneko, G. Wakabayashi, Validation of a difficulty scoring system for laparoscopic liver resection: a multicenter analysis by the endoscopic liver surgery study group in Japan, in Journal of the American College of Surgeons, 2017.
48) T. Saito, S.T. Chew, W.L. Liu, K.K. Thinn, T. Asai, K.K. Ti, A proposal for a new scoring system to predict difficult ventilation through a supraglottic airway, in Br J Anaesth, 2016, 117 Suppl 1:i83-i86.
49) P. Piras, Imperitia sine culpa non datur. A proposito del nuovo art. 590 sexies c.p., in Diritto Penale Contemporaneo, 2017.
50) ECDC country visit to Italy to discuss antimicrobial resistance issues (2017), Mission report 9-13 January 2017, ECDC.
51) R.DS. Bliss, P.G. Gauger, L.W. Delbridge, Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique, in World J Surg, 2000, 24(8):891-7.
52) M.N. Hadley, C.D. Shank, C.J. Rozzelle, B.C. Walters, Guidelines for the Use of Electrophysiological Monitoring for Surgery of the Human Spinal Column and Spinal Cord. Neurosurgery, 2017.
1) American College of Legal Medicine, The Medical Malpractice Survival Handbook, 2007, Mosby.
2) M.A. Makary, M. Daniel, Medical error-the third leading cause of death in the US, in BMJ, 2016, 353:i2139.
3) M.M. Mello, A. Chandra, A.A. Gawande, D.M., National costs of the medical liability system, in Health Aff (Millwood), 2010, 29(9):1569-77.
4) Commissione parlamentare di inchiesta sugli errori in campo sanitario e sulle cause dei disavanzi sanitari regionali. Relazione conclusiva. Approvata dalla commissione nella seduta del 22 gennaio 2013.
5) T. Delbanco, S.K. Bell, Guilty, afraid, and alone-struggling with medical error, in New Engl J Med., 2007.
6) F. Basile, Itinerario giurisprudenziale sulla responsabilità medica colposa tra art. 2236 cod. civ. e Legge Balduzzi (aspettando la riforma della riforma), in Diritto penale contemporaneo, 2017.
7) L., Donaldson, An organisation with a memory, in Clin Med JRCPL, 2002, 2:452–7.
8) P. McCulloch, A. Mishra, A. Handa, T. Dale, G. Hirst, K. Catchpole, The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre, in Qual. Saf. Health Care, 2009, 18;109-115.
9) S.O. Rogers Jr, A.A. Gawande, M. Kwaan, A.L. Puopolo, C. Yoon, T.A. Brennan, D.M. Studdert, Analysis of surgical errors in closed malpractice claims at 4 liability insurers, in Surgery, 2006, 140(1):25-33.
10) Institute of Medicine (US) Committee on Quality of Health Care in America; L.T. Kohn, J.M. Corrigan, M.S. Donaldson, editors, To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US), 2000.
11) A. Kachalia, M.M. Mello, B.K. Nallamothu, D.M. Studder, Legal and Policy Interventions to Improve Patient Safety, in Circulation, 2016, 133(7):661-71.
12) B. Sonny Bal, An Introduction to Medical Malpractice in the United States, in Clin Orthop Relat Res, 2009.
13) P.P. Budetti, T.M. Waters, Medical Malpractice Law in the United States, Kaiser Family Foundation, 2005.
14) M. Caputo, “Filo d’arianna” o “flauto magico”? Linee guida e checklist nel sistema della responsabilità per colpa medica, in Diritto penale contemporaneo, 2012.
15) M.M. Mello, A. Kachalia, D.M. Studdert, Medical Liability - Prospects for Federal Reform, in N Engl J Med, 2017, 376(19):1806-1808.
16) A. Kachalia, A. Little, M. Isavoran, L.M. Crider, J. Smith, Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians, in Health Affairs, 2014, 59-66.
17) M.M. Mello, A, Kachalia, Medical malpractice: evidence on reform alternatives and claims involving elderly patients, Washington, 2016, DC: Medicare Payment Advisory Commission.
18) National Academies of Sciences, Engineering, and Medicine, Improving diagnosis in health care, Washington, 2015, DC: The National Academies Press.
19) C. Brusco, Cassazione e responsabilità penale del medico. Tipicità e determinatezza nel nuovo art. 590-sexies c.p., in Diritto penale contemporaneo, 2017.
20) Cass. Pen. Sez. IV, 9 aprile 2013, n. 16237.
21) M.J. Mehlman, Medical Practice Guidelines as Malpractice Safe Harbors: Illusion or Deceit?, in J Law Med Ethics, 2012, 40(2):286-300.
22) P. Glasziou, Evidence based medicine and the medical curriculum, in BMJ, 2008, 337-a1253.
23) Disponibili su https://snlg.iss.it (Visionato il 25 gennaio 2019).
24) R.B. D’Agostino Sr, B.J. Ansell, S. Mora, H.M. Krumholz, Clinical decisions. The guidelines battle on starting statins, in N Engl J Med., 2014.
25) Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Guidelines for the Use of Laparoscopy during Pregnancy, 2017.
26) Diagnosi e trattamento delle epilessie. Linee Guida - Consiglio Sanitario Regionale - Regione Toscana 2014.
27) R. Blaiotta, La responsabilità medica: nuove prospettive per la colpa, in Diritto Penale Contemporaneo, 2010.
28) P. Glasziou, A. Burls, R. Gilbert, Evidence based medicine and the medical curriculum, in BMJ, 2008, 337-a1253.
29) M. Caputo, Colpa penale del medico e sicurezza delle cure, Giappichelli Editore, 2017.
30) N.J. Dedy, E.M. Bonrath, N. Ahmed, T.P. Grantcharov, Structured Training to Improve Nontechnical Performance of Junior Surgical Residents in the Operating Room: A Randomized Controlled Trial, in Ann Surg, 2016, 263(1):43-9.
31) R. Krage, L. Zwaan, L. Tjon Soei Len, M.W. Kolenbrander, D. van Groeningen, S.A. Loer, C. Wagner, P. Schober, Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?, in Emerg Med J, 2017, 34(11):728-733.
32) R.A. Agha, A.J. Fowler, N. Sevdalis, The role of non-technical skills in surgery, in Ann Med Surg (Lond), 2015, 4(4):422-7.
33) T.C. Wood, N. Raison, S. Haldar, O. Brunckhorst, C. McIlhenny, P. Dasgupta, K. Ahmed, Training Tools for Nontechnical Skills for Surgeons-A Systematic Review, in J Surg Educ, 2017, 74(4):548-578.
34) S. Yule, R. Flin, S. Paterson-Brown, N. Maran, Non-technical skills for surgeons in the operating room: a review of the literature, 2006, Surgery;139(2):140-9.
35) M.A. Abid, Y.W. Li, C.W. Cummings, N.I. Bhatti, Patient outcomes as a measure of surgical technical skills: Does surgical competency matter?, in A systematic review. Otorinolaringologia, 2016.
36) J.D. Birkmeyer, J.F. Finks, A. O’Reilly, M. Oerline, A.M. Carlin, A.R. Nunn, J. Dimick, M. Banerjee, N.J. Birkmeyer, Michigan Bariatric Surgery Collaborative, Surgical skill and complication rates after bariatric surgery, in N Engl J Med, 2013, 369(15):1434-42.
37) K.R. Ghani,D.C. Miller, S. Linsell, A. Brachulis, B. Lane, R. Sarle, D. Dalela, M. Menon, B. Comstock, T.S. LendvayS, J. Montie, J.O. Peabody, Michigan Urological Surgery Improvement Collaborative, Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy, in Eur Urol, 2016, 69(4):547-550. doi: 10.1016/j.eururo.2015.11.028. Epub 2016 Jan 2.
38) K. Moorthy, Y. Munz, S.K. Sarker, A. Darzi, Objective assessment of technical skills in surgery, in BMJ, 2003, 327(7422):1032-7.
39) V.L. Pascali, Legalità e eticità nelle condotte mediche. Alcune considerazioni all’ombra della legge Gelli-Bianco, in Medicina e Morale, 2018, 6: 613-617.
40) C.M. Schulz, M.R. Endsley, E.F. Kochs, A.W. Gelb, K.J. Wagner, Situation Awareness in Anesthesia, in Anesthesiology, 2013, 118:729-42.
41) M.A. Corvetto, C. Fuentes, A. Araneda, P. Achurra, P. Miranda, P. Viviani, F.R. Altermatt, Validation of the imperial college surgical assessment device for spinal anesthesia, in BMC Anesthesiol, 2017, 17(1):131.
42) E.X. Vivas, M.L. Carlson, B.A. Neff, N.T. Shepard, J. McCracken, A.D. Sweeney, J.J. Olson, Congress of Neurological Surgeons, Systematic Review and Evidence-Based Guideline on Intraoperative Cranial Nerve Monitoring in Vestibular Schwannoma Surgery, 2017.
43) J. Bergs, J. Hellings, I. Cleemput, Ö Zurel, V. De Troyer, M. Van Hiel, J.L. Demeere, D. Claeys, D. Vandijck, Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications, in Br J Surg, 2014, pp. 150–8.
44) D. Ban, M. Tanabe, H. Ito, Y. Otsuka, H. Nitta, Y. Abe, Y. Hasegawa, T. Katagiri, C. Takagi, O. Itano, H. Kaneko, G. Wakabayashi, A novel difficulty scoring system for laparoscopic liver resection, in J Hepatobiliary Pancreat Sci, 2014, 21:745–753.
45) C. Im, J.Y. Cho, H.S. Han, Y.S. Yoon, Y. Choi, J.Y. Jang, H. Choi, J.S. Jang, S.U. Kwon, Validation of difficulty scoring system for laparoscopic liver resection in patients who underwent laparoscopic left lateral sectionectomy, in Surg Endosc, 2017, 31(1):430-436.
46) H. Uchida, Y. Iwashita, K. Saga, H. Takayama, K. Watanabe, Y. Endo, K. Yada, M. Ohta, M. Inomata, Clinical Utility of the Difficulty Scoring System for Predicting Surgical Time of Laparoscopic Liver Resection, in J Laparoendosc Adv Surg Tech A, 2016, 26(9):702-6.
47) S. Tanaka, S. Kubo, A. Kanazawa, Y. Takeda, F. Hirokawa, H. Nitta, T. Nakajima, T. Kaizu, H. Kaneko, G. Wakabayashi, Validation of a difficulty scoring system for laparoscopic liver resection: a multicenter analysis by the endoscopic liver surgery study group in Japan, in Journal of the American College of Surgeons, 2017.
48) T. Saito, S.T. Chew, W.L. Liu, K.K. Thinn, T. Asai, K.K. Ti, A proposal for a new scoring system to predict difficult ventilation through a supraglottic airway, in Br J Anaesth, 2016, 117 Suppl 1:i83-i86.
49) P. Piras, Imperitia sine culpa non datur. A proposito del nuovo art. 590 sexies c.p., in Diritto Penale Contemporaneo, 2017.
50) ECDC country visit to Italy to discuss antimicrobial resistance issues (2017), Mission report 9-13 January 2017, ECDC.
51) R.DS. Bliss, P.G. Gauger, L.W. Delbridge, Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique, in World J Surg, 2000, 24(8):891-7.
52) M.N. Hadley, C.D. Shank, C.J. Rozzelle, B.C. Walters, Guidelines for the Use of Electrophysiological Monitoring for Surgery of the Human Spinal Column and Spinal Cord. Neurosurgery, 2017.
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